Nokea
A married man expresses to the nurse that his wife's frequent nagging angers him. The nurse role-plays assertive communication techniques with the husband. Which of the following indicates the husband understands how to use assertive techniques effectively?
- A. I really wish you would stop nagging me
- B. If you are not perfect either
- C. I feel unappreciated when you criticize me
- D. Are you telling me you want me to change?
Correct Answer: C
Rationale: Assertive communication uses 'I' statements to express specific feelings, like feeling unappreciated, fostering productive dialogue, unlike vague wishes or defensive questions.
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Which of the following interventions are most effective in managing the environment to reduce or eliminate aggressive behavior?
- A. Planning group activities such as playing games
- B. Scheduling one-to-one interactions with the client
- C. Providing structure and consistency in the unit
- D. Avoiding discussions among clients on the unit
- E. Discouraging clients from negotiating solutions
Correct Answer: A,B,C
Rationale: Group activities, one-to-one interactions, and consistent structure foster a calm environment and reduce aggression, unlike avoiding discussions or negotiation.
A client who has been physically aggressive arrives at the emergency room for a psychiatric assessment. Which would be the best approach for the nurse to use?
- A. Have a sense of humor to show a lack of fear.
- B. Provide close contact to increase the client's sense of safety.
- C. Use brief statements and questions to obtain information.
- D. Use open-ended questions, so the client can elaborate.
Correct Answer: C
Rationale: Brief statements and questions facilitate communication with an aggressive client who may struggle to express themselves, unlike humor or open-ended questions, which may escalate tension.
The nurse observes two clients in the day room arguing. One client runs into the corner and huddles while the other follows and continues with verbal abuse. Which is the best action by the nurse?
- A. Take an authoritative step between the two clients.
- B. Comfort the client huddled in the corner.
- C. Directly address both clients and ask what is going on.
- D. Engage the attention of the client who is still yelling and ask what is happening.
Correct Answer: D
Rationale: Engaging the dominant client de-escalates the situation by redirecting their focus, avoiding physical intervention or ignoring the aggressor's behavior.
A client is clenching his fists and yelling at another client on the unit. He appears to be close to losing control of his anger. Which of the following actions by the nurse is appropriate at this time?
- A. Clear others out of the immediate area.
- B. Prepare a PRN sedative.
- C. Tell the client to stop and take a time-out.
- D. Alert the security department of an impending aggressive outburst.
Correct Answer: C
Rationale: Directing the client to take a time-out during the escalation phase is a least restrictive intervention to regain control, prioritizing de-escalation over sedatives or security.
A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints. Which statement should the nurse make to explain the use of restraints to the client?
- A. The length of time you'll be in restraints is undetermined.
- B. The staff will monitor your behavior closely.
- C. This is what happens when you lose control.
- D. This is a means of keeping you and others safe.
Correct Answer: D
Rationale: Explaining restraints as a safety measure clarifies their purpose without implying punishment, unlike vague or punitive statements.